Organization
REJUVENATION MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA KRETCHMAR (DO)
(817) 789-2639
Entity
Organization
Contact information
Practice address
20011 BALLINGER WAY NE, SHORELINE, WA 98155-1286
(206) 407-4171
(206) 906-9981
Mailing address
20011 BALLINGER WAY NE, SHORELINE, WA 98155-1286
(206) 407-4171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP60765453
LICENSE
WA
Enumeration date
04/05/2019
Last updated
04/05/2019
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